Coincidence of Nutritional Habits and Esophageal Cancer in Germany

Abstract

Introduction: The incidence rates for adenocarcinoma (AC) of the esophagus have risen rapidly in Western nations, whereas the incidence rates for esophageal squamous cell carcinoma (SCC) have remained nearly stable. There are studies about body mass index, smoking, alcohol, and development of AC or SCC. The aim of this study was to evaluate differences in nutritional habits of patients with AC or SCC compared with the population in Cologne. Patients and Methods: From January 1, 1997 to December 31, 1998, 85 patients with esophageal cancer (SCC n = 45, AC n = 40) were interviewed about their nutritional habits using a computerized program (EBIS). By random sample, 100 citizens of Cologne who were similar of age, residence, and nationality were chosen as healthy control group (CG) and were also interviewed with EBIS. Results: The known risk factors, alcohol and tobacco for SCC as well as alcohol and a high body mass index for AC, were confirmed in this study. The CG had a higher daily intake of calcium, magnesium and iron compared to patients with esophageal cancer (p < 0.05). In addition, the tumor group had a significant lower daily supply of carbohydrates, fruits, and dietary fiber (p < 0.001). About 80% of the patients ate more than 100 g meat/day in comparison to 50% of participants in the CG. Patients with AC consumed more magnesium, milk, and animal protein than patients with SCC or the participants of the CG. Conclusion: There are differences in nutrition between healthy controls and patients with esophageal cancer and between patients with SCC and AC. Patients with cancer of the esophagus had a nutritonal deficit in fresh fruit, vegetables, dietary fiber, and carbohydrates. Compared with the other groups, patients with AC had a higher intake of protein, fat, and milk.

Fruit and vegetable intake and esophageal cancer in a large prospective cohort study

“…12,16,30,31 In contrast, the association between fruit and vegetable intake and EAC risk has been inconsistent. Some previous studies observed significant Adjusted for sex, age at entry into cohort, BMI, education, alcohol intake, cigarette-smoke-dose, vigorous physical activity, usual activity throughout the day, and total energy.- inverse associations with fruit intake, 33,34 vegetable intake [35][36][37] and combined fruit and vegetable intake. 15 Other studies observed suggestive but nonsignificant inverse associations with fruit [35][36][37][38] and vegetables.…”

Molecular Biology of Esophageal Cancer

“…Besides Plummer-Vinson syndrome and scleroderma, achalasia and chronic mucosal irritation are also known risk factors. Additional risk factors for the development of ESCC are nutritional factors like the presence of nitrosamines in the food and vitamin deficiency [2]. Contrary to ESCC the most important risk factor for the development of EAC is the presence of columnar-lined esophagus (CLE), also known as Barrett's esophagus.…”

Esophageal cancer in Germany is associated with Epstein-Barr-virus but not with papillomaviruses

“…Chronic gastro-esophageal reflux leading to metaplasia and Barrett esophagus is regarded as major risk factor [22]. Additional etiological agents are in discussion [19,23,36,43].…”